Brexanolone Disease Interactions

The effect of end stage renal disease (ESRD, eGFR < 15 mL/minute/1.73 m2) on brexanolone pharmacokinetics is unknown, and its use should be avoided in these patients because of the potential accumulation of the solubilizing agent, betadex sulfobutyl ether sodium. No dosage adjustment is recommended in patients with mild (eGFR 60 to 89 mL/minute/1.73 m2), moderate (eGFR 30 to 59 mL/minute/1.73 m2) or severe (eGFR 15 to 29 mL/minute/1.73 m2) renal impairment.

Brexanolone is indicated for the treatment of postpartum depression. A placebo-controlled trial showed that patients with a previous diagnosis of major depressive disorder (MDD) had a higher incidence of suicidal thoughts and behaviors when treated with brexanolone. Consider changing the therapeutic regimen, including discontinuing brexanolone, in patients whose depression becomes worse or who experience emergent suicidal thoughts and behaviors.